Living in the present, planning for the future

Kathleen Gallagher’s mind was reeling as she sat in the emergency room while her husband — too young for this kind of thing — was beyond the doors being treated for a heart attack.

“I sat in the waiting room not knowing how he was, not knowing what was going on at the time,” she said.

But one thing she didn’t have to worry about was what her husband’s wishes for treatment were or whether she would be able to make those decisions on his behalf. Years before, Gallagher and her husband had each filled out health care proxy forms.

Luckily, Gallagher’s husband has recovered, but the event cemented for her the importance of making end-of-life health care decisions while one is still fully capable of articulating one’s wishes. “It wasn’t something hanging out there, another worry for me to have in the middle of all of this,” she said.

Gallagher is the director of Pro-Life Activities for the New York State Catholic Conference, and she said her phone rings several times each week with someone calling for more information on what the Church teaches about end-of-life medical treatment.

Now, a new publication by the Catholic bishops of New York State entitled “Now and at the Hour of Our Death: A Catholic Guide to End-of-Life Decision-Making” guides parishioners toward the right answers.

At 15 pages, the booklet is brief and very easy to understand, yet it also provides clear direction on the moral implications of ever-advancing medical technologies and treatments meant to prolong life. The booklet will be made available to pastors, deacons and chaplains throughout the Syracuse Diocese. A copy of the booklet can also be mailed to those interested at no cost. (See related box on page 4 for more information) At the end of the book is a health care proxy form which can be filled out, copied and given to loved ones, lawyers and doctors.

“This booklet is very useful for all Catholics,” said Lisa Hall, director of the diocesan Respect Life Office. “Scripture says ‘We know not the day or hour of our death,’ so it’s very important to understand what the Church teaches.”

Hall said the Respect Life Office can provide guidance on these issues, and those who would like to arrange for presentations in parishes on end-of-life decision-making can call her office to set up a time.

“As Catholics, we try to make these decisions in light of Catholic teaching,” Hall said. “But because we live in a time when medical technology is advancing so quickly, we need full clarification about the choices to be made at the end of life. That’s why this booklet is particularly helpful in trying to deepen the understanding of Church teaching. And they’ve made this about as user-friendly as can be done.”

Father Charles Vavonese said Gallagher will be making presentations to both the Catholic Medical Association and the Catholic Lawyers Guild on end-of-life decision making. “Each of these groups is in a position to interact with typical Catholics,” Father Vavonese said. “Helping lawyers to understand and helping doctors to understand Church teaching on these issues really means that they may be able to actually interact with and educate their clients as well.”

This fall, doctors in the Catholic Medical Association will be providing parish presentations on end-of-life treatments and the decisions to be made. Those who are interested in having a presentation in their parish can contact Father Vavonese to arrange a date. (See related box for more information)

“A common misperception is that Church teaching in this area is all about saying no. ‘No, you’re not able to unhook that machine.’ But that’s not true. The Church says yes to life. But life does not have to be prolonged at all costs,” Gallagher said.

Benefits need to be weighed against burdens. For example, is the treatment very costly, very painful and only going to add a few more days to the dying process? These decisions need to be made on an individual basis with the understanding that allowing one to die naturally is not the same as killing.

“A lot of times people … want black and white answers. Well, Church teaching in this area is kind of gray,” Gallagher said. “That’s when that person’s priest or chaplain or ethical advisor comes in and can be very helpful.”

But once a person understands and has decided what they would like to have in terms of health care treatment at the end of their life, it’s important to appoint a health care proxy to be sure that these wishes are carried out. A health care proxy is an agent who makes decisions on one’s behalf, rather than a living will which is a document which puts down in writing one’s wishes for future treatment.

In the Catholic guide published by the bishops, health care proxies are preferred over living wills because medical advances and changes in a patient’s situation may make the directions set down in a living will irrelevant or even unwanted.

“It’s far better to appoint a health care proxy so you can have an agent that can make these decisions for you 10, 20, 30 years down the road,” Gallagher said. A spouse or a child can make the right decisions because he or she knows the patient so well. “It’s a living person, not a dead piece of paper.”

These decisions are never easy ones to make, Father Vavonese said, but doing so takes the burden off loved ones who will be dealing with their own feelings of grief and loss during the dying process. As confusing and uncomfortable as the decisions are now, imagine how much more so they would be in a hospital room or doctor’s office.

“It’s a reality, and probably some of the most difficult instances are when there is a young person involved,” Father Vavonese said. “It does help to take some of the burden from the survivors.”

Gallagher said this is why it’s important to think about these decisions no matter one’s age. “Planning for end-of-life decision-making is not just for the elderly and the terminally ill,” she said. “It’s for the young and the old, the healthy and the sick. It’s for everyone.”